Clinical Study of 20 Cases of Severe Japanese Cedar Pollinosis Treated with Omalizumab

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  • オマリズマブを使用した重症スギ花粉症20例の臨床的検討
  • オマリズマブ オ シヨウ シタ ジュウショウ スギ カフンショウ 20レイ ノ リンショウテキ ケントウ

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Abstract

<p>　Among patients with seasonal allergic rhinitis, there is a subgroup of patients with severe or most severe disease, for whom existing treatments are not sufficiently effective. In December 2019, omalizumab was approved for the treatment of such severe cases of seasonal allergic rhinitis. Because it is a very expensive drug, this study was conducted with the aim of finding precautions for proper use. We analyzed 20 patients with severe Japanese cedar pollinosis treated with omalizumab who visited our department in 2021 and determined the effects of omalizumab on their quality of life and labor productivity using the Japanese Rhinoconjunctivitis Quality of Life Questionnaire (JRQLQ) and Work Productivity and Activity Impairment-Allergy Specific (WPAI-AS). The questionnaire survey was conducted at the time of the first administration of omalizumab and approximately 1 month later, and the results were compared. The results indicated improvement of both the JRQLQ and WPAI-AS scores. In addition, in the final survey, 15 of the 18 patients who were available to respond to our question indicated that they were happy with having used omalizumab for their symptoms that year. As adverse events, one 81-year-old man developed polymyalgia rheumatica after the second dose. The drug proved ineffective in one 53-year-old woman; this patient was sensitized to multiple antigens, and had coexistent bronchial asthma and perennial rhinitis. She showed no subjective improvement of the nasal congestion after omalizumab treatment. For treating the nasal congestion in this patient, the cause needs to be scrutinized more carefully, and the combination of immunotherapy or surgery may be considered. The effects of omalizumab and the satisfaction level with the treatment were generally high for patients with severe Japanese cedar pollinosis, but because it is an expensive drug, it is important to identify the correct candidates for treatment with omalizumab, to ensure appropriate use of the drug.</p>

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